Code R53.2 Functional Quadriplegia has shifted from DRGs
052/053 to 947/948 (Signs and Symptoms with MCC and w/o
MCC). This is a more appropriate DRG when there are also other sign and symptom codes. MS-DRGs 984-986, prostatic OR
proc unrelated to principal diagnosis, moved all procedures to
MS-DRGs 987-989 and deleted MS-DRGs 984-986. It was determined that not enough claims were seen to warrant separate
DRGs for these cases.

The fourteen ICD-10-CM diagnosis codes that describe
observation and evaluation of the newborn for suspected
conditions ruled out (Z05.0-Z05.9) which are currently assigned to MS-DRG 794 (Neonate with Other Significant
Problems) have been shifted to MS-DRG 795 (Normal Newborn). Cases that are assigned one of the codes from category Z05 as either a principal or secondary diagnosis (with
a principal diagnosis from category Z38) will now result in
MS-DRG 795.

There were no changes made to the list of hospital-acquired
conditions (HACs) for F Y 2018.

OR to Non-OR Procedure List Changes

Over 700 ICD-10-PCS procedure codes were shifted from the
Operating Room (OR) Procedure list to the Non-OR Procedure
list for F Y 2018. Non-OR procedures are procedures that typically do not require operating room resources but can be performed at the bedside. Some of the procedures that are now
considered non-OR procedures are:

Endoscopic/transorifice fragmentation of the respiratory
system body parts (0BF table)

Endoscopic insertion of intraluminal devices into the trachea (0BH17DZ, 0BH18DZ)

Several codes in the respiratory system w/revision of (0BW
table) drainage, infusion, intraluminal, or monitoring devices

Some of the MS-DRGs most impacted by the shift of procedures from the OR to Non-OR list are MS-DRGs 853, 571, 632,
570, 464, 264, 981.

CC/MCC Changes to the MS-DRGs

CMS will be doing a detailed review of the CC and MCClists for FY 2019. The last such comprehensive review ofthese lists was done in FY 2008 prior to the implementa-tion of MS-DRGs. For FY 2018, approximately 86 ICD-10-CM diagnosis codes were added to the CC list. Primarily,these were codes already on the list but due to their re-vision for FY 2018 the list is updated. The CC list had ap-proximately 12 codes deleted, which were codes that havebeen expanded for FY 2018 and are now subcategories andtherefore no longer valid codes. Only one code was deletedfrom the MCC list (P29.3) because it was expanded for FY2018 and no longer a valid code.

The following seven ICD-10-CM diagnosis codes (all new
codes for F Y 2018) were added to the MCC list:

P29.30, Pulmonary hypertension of newborn P29.38, Other persistent fetal circulationThe complete CC and MCC lists can be found on tables 6J(CC) and 6I (MCC) in the final IPPS rule in the Federal Register.

New Technology Add-On Payments

These are reviewed each year, resulting in changes and adjustments including the discontinuation, continuation, or addition of new technology add-on payments. For FY 2018 the following new technology items have been discontinued: